Volume 13, Issue 4 (Atumn 2005)
JSSU 2005, 13(4): 30-35 |
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Afshar H, Rouh Afza H, Nuri M, Amanat S. Comparision of the Efficacy of Two Combinations Sodium Valproate with Lithium & Sodium Valproate with Olanzapine in Treatment of Acute Mania. JSSU 2005; 13 (4) :30-35
URL: http://jssu.ssu.ac.ir/article-1-708-en.html
URL: http://jssu.ssu.ac.ir/article-1-708-en.html
Abstract: (7160 Views)
Introduction: Acute mania is a psychiatric emergency state that often requires rapid management. There are
many different therapeutic protocols for this emergent situation. One of them is combination of moodstabilizers
and antipsychotics. Olanzapine which is now available in our country can be used for this purpose.
Methods and Materials: In this study, we compared the effectiveness, rapidity of response and side effects
of sodium valproate plus olanzapine (group I) with sodium valproate plus lithium (group II) in acutely manic
or mixed bipolar patients. In this randomized, double blind, parallel group study, 44 acutely manic or mixed
patients according to DSM IV-TR criteria were randomly assigned to receive combinations of sodium
valproate (20mg/kg per day) with either olanzapine (5-15mg/day) or lithium (900mg/day) during a ten-day course.
Efficacy was measured with Young Mania Rating Scale (YMRS). Effectiveness measures included YMRS
response (YMRS reduction ³ 50%) and YMRS remission (YMRS<=12). Data was entered in SPSS11 software
program and analyzed by Mann-Whitney, Fisher exact test and Wilcoxon tests (P-values < 0.05 were
significant).
Results: Total number of patients were 44 (mean age 27.18±7.34), 21 in group I and 23 in group II.
Response rate was 85.7% (18 patients) and 73.9% (17 patients) in group I and II, respectively with no
significant differences between the two groups(P=0.33). Remission rate was 42.9 %(9 patients) and 43.5%
(10 patients) in group I and II, respectively with no significant differences between two groups(P=0.97). The
reduction in total scores in YMRS on the 2nd, 7th and 10th days of study were significant in both groups
(P<0.05), but the rapidity of response was similar. The rates of adverse effects between two groups were not
statistically significant.
Conclusion: Both combinations of drugs were effective in acutely manic or mixed patients. Both treatments
were safe and well tolerated
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